In-custody suicides can occur at any time during the inmate's incarceration. Staff must diligently be alert to any new cues that an inmate has become suicidal. Talk with the inmate around the time of his sentencing or at any other anticipated critical or stressful period to identify suicidal intent. Any inmate who has a significant change in their legal circumstances or mental health status should immediately be re-evaluated for suicidal thoughts/feelings.
Yes, there are going to be inmates who make manipulative suicidal statements or gestures. There are numerous secondary gains for these inmates: delaying a court appearance, or bolstering an insanity defense, to gain cell relocation, to receive preferential staff treatment, or to seek compassion from unsympathetic family members. Nonetheless, and no matter how frustrating this may be to you or your facility, these individuals need to be placed on a suicide watch.
Additional behaviors that frequently indicate that an inmate is a suicide risk include:
- Evidence that the inmate is experiencing hallucinations or delusions
- Weight loss/gain or changes in appetite or sleep patterns
- Severe aggression or extreme restlessness
- Giving away possessions or placing them into property
- Refusing medications or asking for an increased dosage
- Writing goodbye notes to family/friends or starting a diary.
What to do in an in-custody suicide attempt
Hopefully, you have prepared for this. You have made sure that all emergency rescue equipment has been tested, is in good working order, and readily available. Follow your facilities protocol. Call for internal or external emergency medical staff but don't wait for them to initiate CPR and/or first aid.
What to do if an in-custody suicide occurs
Suicide happens, in-custody and not. It is crucial to debrief any in-custody suicide with correctional, supervisory, medical and mental health staff. In the debriefing, reconstruct the events, try to identify factors that may have led to the suicide, determine if something was missed, assess the emergency response, and discuss possible policy updates to improve any areas that were lacking.
Suicide attempts or completions are obviously extremely problematic for jails. There is a very strong probability that the facility and/or correctional officer will face a lawsuit following any suicidal incident related to federal civil rights or a state wrongful death case filed by the victim's family. The premise of these lawsuits is that prisoners and detainees are under the exclusive control of the facility and its staff, who are ultimately responsible for the inmates' care. Inmates have lost their freedom due to incarceration, which includes the ability to obtain medical or psychological treatment themselves. Courts have found that it is the obligation of the facility and staff to assess for suicidal ideation and intervene appropriately. When a suicide attempt results in death, and a liability is determined the settlement can be quite pricey. Failure to identify suicide risk factors or to take immediate and appropriate action in a suicide attempt is considered deliberate indifference.